治疗和改善缺铁性贫血的研究动向

缺铁性贫血(IDA)是最常见的贫血,严重影响人类的健康。目前主要有铁剂治疗和食品强化铁两种方式。     

大肠癌并发贫血的相关因素探讨

目的分析大肠癌患者的分期、血清白蛋白水平、化疗、性别、年龄等因素与贫血的相关性。方法用Access数据库界面录入2003年1月至2009年5月间收治的251例大肠癌患者病历资料,按UICC大肠癌TNM分期法(1997年)进行分期。运用SPSS12.0统计软件包分析大肠癌贫血的相关因素。结果总贫血发生率为29.88%,男性与女性贫血发生率差异无统计学意义(P>0.05);低蛋白血症和接受化疗的患者贫血发生率均明显高于血清蛋白正常与未化疗者(P<0.005);大肠癌患者不同病理分期其贫血发生率也不完全相同(P<0.05);最终进入Logistic回归模型的危险因素有3个,分别是血清白蛋白水平(X1)、化疗(X2)及分期(X3)。结论大肠癌患者贫血的发生与分期、化疗、血清白蛋白水平有一定关系。     

Environmental exposure of lead and iron deficit anemia in children age ranged 1-5 years: A cross sectional study

Iron (Fe) deficiency is the most common nutritional problem among children and lead (Pb) toxicity is the most common environmental health threat to children all over the world. The objective of this study was to determine blood lead (BPb) levels and prevalence of Fe deficient anemia among 1 to 5 year old children attending day care clinic in pediatric ward of civil hospital Karachi, Pakistan. A total of 340 children of both genders participating in this study, were screened for anemia. Among them 215 were anemic and 125 non-anemic. The anemic group was further divided in two groups on the basis of % hemoglobin (Hb), mild (Hb < 10 g/dL) and severe anemic group (Hb < 8 g/dL), while non-anemic as referent children (Hb > 10 g/dL). The blood samples were analysed for Pb and Fe, along with hematological parameters. The result indicated that anemic children had a higher mean values of Pb in blood than referent children with Hb > 10 g/dL. The Pb levels < 100 μg/L were detected in 40% referent children while 60% of them had > 10 μg/dL. The BPb concentration in severe anemic children (53%) was found in the range of 100-200 μg/L, whereas 47% had > 200 μg/L. The significant negative correlations of BPb level with % Hb (r = −0.514 and r = −0.685) and Fe contents (r = −0.522, r = −0.762, p < 0.001) were observed in mild and severe anemic children respectively. While positive correlation was observed between BPb and age of both group and genders (r = 0.69, p < 0.01). The BPb levels were significantly associated with biochemical indices in the blood which have the potential to be used as biomarkers of Pb intoxication and Fe deficient anemia.     

Anemia management in chronic kidney disease

Anemia is common in chronic kidney disease (CKD) due to a state of erythropoietin deficiency. Erythropoietin therapy has been used for approximately 20 years to correct anemia in CKD and to improve both subjective and objective outcomes. Guidelines that establish a hemoglobin (Hb) goal for anemia correction in CKD patients are largely based on observational data. Controversy still exists, however, because outcomes have not been consistent with various degrees of anemia correction. The number of prospective randomized trials investigating the effects of anemia correction on cardiovascular (CV) morbidity and mortality in CKD patients, an already high-risk group, is limited. With respect to improving CV outcomes in the CKD population, the currently available trial data caution against raising Hb levels in CKD patients to approach more "normal" physiologic ranges. The disappointing experience with the trial data must be weighed against the beneficial associations of erythropoietin therapy that have been generated from observational data. Establishing the ideal target Hb ranges for anemia correction in CKD patients remains a dynamic process and leaves many gray areas to be further elucidated. Here, we present a case that underscores the need to consider the study design when reviewing the data at a population level in order to determine what is most appropriate for our patient.     

A community food system analysis as formative research for a comprehensive anemia control program in Northern Afghanistan

Dietary strategies to reduce chronic iron deficiency anemia are still lacking for the rural poor in most developing countries. This study of 60 households (30 irrigated zone, 30 rainfed zone) in northern Afghanistan emphasized women’s seasonal food consumption and the relationships between household capacities and consumption. In both zones, iron-rich foods and foods affecting iron bioavailability were consumed in summer and winter diets. Households in the irrigated zone had more capacity for cultivation, food preservation and social networking in addition to owning more total livestock and food animals. Rainfed zone households scored higher on food preservation knowledge. Iron-rich food consumption was strongly associated with social networking and food preservation capacities, but weakly with socioeconomic proxies. Social networking showed no relationships to socioeconomic proxies. Agroecozone, social customs and food combinations should be considered in the design of health and food security programs to reduce anemia risk.

Effects of iron supplementation versus dietary iron on the nutritional iron status: Systematic review with meta-analysis of randomized controlled trials

ABSTRACT

This meta-analysis compared the effects of dietary intervention versus iron supplementation on biochemical parameters related to the iron nutritional status in humans. The PubMed, CENTRAL, LILACS, SCIELO, OPENGREY.EU and ClinicalTrials.gov databases were searched for randomized clinical trials that assigned individuals to a dietary intervention or to an iron supplementation regimen, for 12 weeks or more. The primary outcome was the hemoglobin concentration, and secondary outcomes were ferritin, RDW, mean corpuscular volume, soluble transferrin receptor, total iron binding capacity, serum iron, and transferrin saturation. From the 6095 records identified, twelve studies were included, six with children, five with adolescents/adults, and one with pregnant women. In the subgroup of studies that included anemic/iron deficient children, supplementation significantly increased the hemoglobin concentration (weighted mean difference (WMD): 3.19 g/L [95% CI: 1.31, 5.07]) and induced a significantly greater reduction of the soluble transferrin receptor (WMD: ?0.46 mg/L [95% CI: ?0.70, ?0, 21]), when compared to dietary intervention. It also induced a greater reduction of the total binding capacity of iron in adolescents/adults (WMD: ?6.96 μmol/L [95% CI: ?12.70, ?1.21]). Supplementation showed a better effect on hemoglobin recovery in anemic/iron deficient children, while no differences were observed between supplementation and dietary intervention in treating adolescents/adults.